Weird interview questions and ANSWERS!

[cooldude5555]

Ethics question involving patients who do not want treatment and how to treat them.

how would you answer this question in an interview?

I would say:

"As a physician, it is my responsibility to offer the treatment to the patients, however I cannot force it upon them. I would try consulting other family members and try to convince them as to how vital a treatment may be to the survival of their loved one."



Keep more coming, but ANSWER them!! thats the hard part

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[Tropicana100]

Ethics question involving patients who do not want treatment and how to treat them.

how would you answer this question in an interview?

I would say:

"As a physician, it is my responsibility to offer the treatment to the patients, however I cannot force it upon them. I would try consulting other family members and try to convince them as to how vital a treatment may be to the survival of their loved one."



Keep more coming, but ANSWER them!! thats the hard part

Your answer is wrong. Privacy laws dictate that you cannot discuss health conditions with family members without patient consent.

 

[Rikkye]

I believe that I would do the same. I would not treat a patient who does not want treatment. It's their right.

However, note that this answer is HYPOCRISY.

When someone wants to commit suicide, we wouldn't let them. Sick patients are in effect commiting an indirect suicide. It's interesting to see how we, as a society, uphold "do not treat" decision but not "suicide" decision. Afterall, isn't that the same?

 

[Bacchus]

Mildly related to this, I saw it on Untold Stories of the ER (which I just watched two episode of). For religious reasons a mother restricted care of her child. The doctor, obviously upset at the life threatening condition had a court ran by a judge in the hospital. The honor found in favor of the child's well-being so the doctor got to do the treatment. What did the mother end up saying to the doctor? Thank you so much, I knew if God wanted "Jimmy" to get better he would. Wierd.

 

[Medicine929]

It is the same with Jehovah's witnesses when they refuse blood transfusions. There is nothing you can do. I am sure there is a long list of when religious beliefs run into medical emergencys. There actually was this private practice doctor that ran his own clinic and refused care on the daughter because her mom had tattoos.

 

[CubaLibre]

honoring a patient's right to refuse medical treatment is not the same as assisting in suicide or even the responsibility to stop suicide. Society appropriately condemns any intentional action to end life. Medical care is a two-way street and requires patient consent. Doctors can't just go around treating patients that don't want to be treated or that refuse a specific procedure, just like an enthusiastic mechanic can't go around fixing antique cars he doesn't own just because he doesn't want to see a classic go to the scrap yard. Terrible analogy, I know, a person's life is at stake. I am not religious, but I am not about to discount or ignore a person's spirituality because for many people, spiritual beliefs define their whole existence. With that said... when it's a child, all that goes out the window!

 

[Rock Solid]

Ethics question involving patients who do not want treatment and how to treat them.

how would you answer this question in an interview?

I would say:

"As a physician, it is my responsibility to offer the treatment to the patients, however I cannot force it upon them. I would try consulting other family members and try to convince them as to how vital a treatment may be to the survival of their loved one."



Keep more coming, but ANSWER them!! thats the hard part

I have been a PA for the past 3.5 years in a very busy cardiology practice. Our duties include hospital work as well as clinic work.
The answer to this question, while complex at first appearance...well, is very simple. You do what the patient wants to have done as long as your actions do not accelerate the dying process (euthenasia, etc). If the patient doesnt want family to know...you cant tell them. If the patient is ready and willing to die...you cant stop them.
Quick scenario: we recently had an ICU patient that was intubated for CHF and pneumonia. She was later extubated and had decreasing oxygen saturation and was required to be re-intubated. While on the vent the second time she convinced her family that she wanted to withdraw support. I mind you, she was coherant and aware as she was not requiring any sedatives at this point. She and her family requested that support be withdrawn..despite the fact that she had two TREATABLE conditions (CHF, and pneumonia). So, we withdrew support, extubated her at her and her families request...and she later went into repiratory arrest and died. So, you are required by law to abide by the patients wishes, as long as those wishes do not require attempts at "euthansia". Interesting story though.

 

[mmcnam]

Mildly related to this, I saw it on Untold Stories of the ER (which I just watched two episode of). For religious reasons a mother restricted care of her child. The doctor, obviously upset at the life threatening condition had a court ran by a judge in the hospital. The honor found in favor of the child's well-being so the doctor got to do the treatment. What did the mother end up saying to the doctor? Thank you so much, I knew if God wanted "Jimmy" to get better he would. Wierd.

Yeah, the Supreme Court has made several rulings in favor of children to receive all necessary medical care when a doctor's opinion clashes in favor of a family's beliefs. The idea is that children are not yet old enough to have properly formed their religious convictions and that, while parents can be martyrs and refuse blood transfusions etc, children should not. In cases like these, temporary custody of the child is often transferred to the doctor or the state. Has anyone read The Spirit Catches You and You Fall Down by Anne Fadiman? It talks a lot about the ethics of such decisions.

 

[Depakote]

The scrubs episode "My Old Lady" (season 1 ep 4) covers this topic nicely... I recommend you watch it.

In general, if you don't have reason to believe the patient is under duress or mentally incompetent, then you should abide by their wishes... even if they decline lifesaving treatment.

 

[Repeat]

I have been a PA for the past 3.5 years in a very busy cardiology practice. Our duties include hospital work as well as clinic work.
The answer to this question, while complex at first appearance...well, is very simple. You do what the patient wants to have done as long as your actions do not accelerate the dying process (euthenasia, etc). If the patient doesnt want family to know...you cant tell them. If the patient is ready and willing to die...you cant stop them.
Quick scenario: we recently had an ICU patient that was intubated for CHF and pneumonia. She was later extubated and had decreasing oxygen saturation and was required to be re-intubated. While on the vent the second time she convinced her family that she wanted to withdraw support. I mind you, she was coherant and aware as she was not requiring any sedatives at this point. She and her family requested that support be withdrawn..despite the fact that she had two TREATABLE conditions (CHF, and pneumonia). So, we withdrew support, extubated her at her and her families request...and she later went into repiratory arrest and died. So, you are required by law to abide by the patients wishes, as long as those wishes do not require attempts at "euthansia". Interesting story though.

You don't have to give a patient the treatment they want if you think it won't help them. Just to make it clear

Is euthanasia illegal in any situation in de US? Or are there any exceptions ?

 

[mvenus929]

Is euthanasia illegal in any situation in de US? Or are there any exceptions ?

As far as I know, Euthanasia is only legal in the Netherlands and Belgium. They've recently had a spike in doctors euthanizing patients that did not make the decision themselves, too.

 

[ChristianJames1]

As far as I know, Euthanasia is only legal in the Netherlands and Belgium. They've recently had a spike in doctors euthanizing patients that did not make the decision themselves, too.

Oregon also has a law that allows physicians to prescribe a drug for terminally ill patients with less than 6 months to live. It is not the same as true euthanasia but it is definitely a form of assisted suicide. I believe California also has a similar bill in the works though I don't know if it will ever make it.

As for the difference between suicide and allowing a patient to refuse care...there is a big difference. In a death related to allowing a patient to refuse service, it is the disease that ultimately ended the person's life. A suicide results in death caused by the person, not a disease. Killing is usually defined by the intentional taking of life. Thus suicide is a form of killing while death from illness is simply death. We have a responsibility to prevent killing in all situations, but not death. Death is part of life.

 

[Meatwad]

As far as I know, Euthanasia is only legal in the Netherlands and Belgium. They've recently had a spike in doctors euthanizing patients that did not make the decision themselves, too.

Bit more complicated. A good synopsis of different countries' stances can be found on wikipedia.

http://en.wikipedia.org/wiki/Euthan...us.2C_and_other_non-governmental_policymaking

 

[Smctbone]

As far as I know, Euthanasia is only legal in the Netherlands and Belgium. They've recently had a spike in doctors euthanizing patients that did not make the decision themselves, too.

i thought Oregon had that "Death with Dignity" Law. Terminally ill patients can get a prescription for a lethal dose of medicine. Granted it's not "euthanasia"...but physician assisted suicide isnt far off.

 

[Bacchus]

Death with Dignity is exactly what you say... physician assisted suicide. It cannot be compared to the Netherlands. The Netherlands is at most very, very loosely under control. I have not read a lot about Belgium's practices. However, Oregon does deserve its own category in this matter.

 

[limpkitty]

The scrubs episode "My Old Lady" (season 1 ep 4) covers this topic nicely... I recommend you watch it.

In general, if you don't have reason to believe the patient is under duress or mentally incompetent, then you should abide by their wishes... even if they decline lifesaving treatment.

Hahahaha, I'm gonna cite that episode when I get asked about this in an interview.

 

[KeyzerSoze]

What's so weird about that question?

 

[tonguepiercing]

Death with Dignity is exactly what you say... physician assisted suicide. It cannot be compared to the Netherlands. The Netherlands is at most very, very loosely under control. I have not read a lot about Belgium's practices. However, Oregon does deserve its own category in this matter.

Belgium does indeed have a liberal approach : abortion, euthanasia, gay marriage, gay adoption, ... But all of these relatively recent changes have been democratically voted after very long debates. I'm from Belgium by the way. We now have these laws that are 'different' from what's is done in many other countries, but after they have been voted and accepted, life goes on. Most people (and that includes me) just think that they are not perfect but still good laws, and we are happy to live in a modern nation.

Now as for euthanasia ... statistics also show that there is in general much less active euthanasia then expected. The number of cases reported are still very low.

In 2007 some minors got press coverage because they too suffered from incurable illnesses and were in pain or distress, and they could not legally get acces to euthanasia. So the public debate started, and the general idea was to modify the existing euthanasia law to include in specific cases also minors. Most people seem to agree, but because we did have some (unrelated) political problems since, the law hasn't changed yet.